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Children and Families/Health: Child Health and Welfare

This report represents the first, exploratory phase of a larger study to learn about the experiences of low income families of children with special needs in finding and keeping child care and balancing work and family. Our interest in this area focused on a number of policy arenas including the child care system, workplace policies, welfare reform and the system of early intervention and special education for children zero to five. We recognized that all of these programs and policies affected employment decisions and strategies and the ability of parents to balance work with the needs of their families. Given the complexity of our study, we chose to begin by conducting qualitative research with families in order to explore what issues were involved and what methodologies in the larger study would best address those issues. Therefore, during the first year of our three-year study, we conducted focus groups and in-depth,semi-structured interviews with parents and guardians of children with special needs. These were held between May 20th and November 13th, 2002.We hope that these and the other findings that emerge from our research will help bring the voices of these parents into the debates about child care, welfare reform and special education that are taking place at the state and federal level. Our aim in conducting the research in the manner we did, was to emphasize for policy makers the importance of looking across policies and programs to understand how the system as a whole affects this population of children and families. By focusing on the families’ experiences first, and then looking at all the sectors of the system which serve them, we hope by the end of this project to provide a sense of where inconsistencies in policies, gaps in services and fragmentation of programs may be making the work/family balance for these families more difficult.

This report, authored by USM Muskie School research staff, presents the results of the 16 CHIPRA Core Measures that were collected using MaineCare claims or Vital Statistics data and reported in the State of Maine’s FFY 2012 CHIP Annual Report to the Centers for Medicare and Medicaid Services (CMS). Also included in this report are an additional three measures from the Improving Health Outcomes for Children (IHOC) project’s Master List of Pediatric Measures. In addition to presenting results in graphs and narrative, this report also provides measure definitions and background information about each measure topic.

The goal of this document is to present the claims- and vital statistics-based CHIPRA and IHOC measure results in a user-friendly format for IHOC project stakeholders. Measures are grouped by topic. For each topic, a Background section provides a brief description and rationale for collection. (The background discussion for CHIPRA Core Measures is drawn from the Background Report for the Initial, Recommended Core Set of Children’s Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs. Available at: http://www.ahrq.gov/chipra/corebackgrnd.htm) Next, we provide a general description of how each measure is defined, followed by the results.

This report, co-authored by Kimberley Fox and Carolyn Gray, provides a final evaluation of the initial phase of First STEPS (Strengthening Together Early Preventive Services), a learning collaborative led by Maine Quality Counts to support 24 pediatric and family practices in improving their childhood immunization rates. The evaluation found that all participating practices had higher immunization rates after participating in First STEPS. On average, overall child immunization rates increased by 5.1% at 12 months and 7.1% at 15 months, and average immunization rates across practices increased significantly from 74.2% to 81.3%. Practices also reported significant improvement in the use of recommended office practices, including staff training, recall/reminder procedures, and the use of data/registries.

This work was conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) authorized by Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA). These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government.

Suggested citation:Fox K, Gray C. Improving Health Outcomes for Children (IHOC) First STEPS Phase I Initiative: Improving Immunizations for Children and Adolescents. (Final Evaluation Report). Portland, ME: University fof Southern Maine, Muskie School of Public Service; March 2013.

Project staff will conduct a telephone survey of parents of children enrolled in MaineCare through three benefit categories (TANF, Medicaid expansion, and SCHIP, the States' Children's Health Insurance Program). The sample will include 1200 current enrollees, 300 disenrollees, and 300 new enrollees. Findings will include satisfaction with providers, satisfaction with MaineCare services, unmet needs, health behaviors, insurance, and employment status.

This project involves a series of surveys and focus groups designed to measure consumer satisfaction, program knowledge, access to health care services and the quality of those services for children who are currently enrolled in MaineCare via the SCHIP eligibility option. Chronic care-related questions will also be added to the surveys this year and a focus group of parents of former SCHIP-enrolled children, who are currently enrolled through Dirigo will be conducted in the summer of 2005.